Hospital tour

Some people might remember me mentioning that I want to tour the
hospital maternity ward just in case there's a complication & I end up
there instead of in the birthing centre. I rang up the midwife today,
and it seems I'll be allowed to gatecrash the NCT (National Childbirth
Trust) tour this Wednesday evening. This is good news, as it seems the
usual tours are just a health care assistant showing you where
everything is, whereas I'd like to be able to find out a bit more about
policies of the place as well. The NCT class should hopefully be asking
quite a lot of questions, so it should be really helpful. I feel like
rather a cheat going along on the tour when I haven't paid my NCT
subscription, but the midwife I spoke to assured me that was quite OK.
;-)

Anyway - now I'm thinking what I should be finding out about, apart from
just generally getting the lay of the land. I'd like to know whether
they have a breastfeeding counsellor & what they do to help women
breastfeed. Also might be useful to know what their policies are about
fetal monitoring, & about eating & drinking in labour.

Anything else anyone can think of that I might want to ask? I'm not
going to bother asking about things like Caesarean rates - stuff like
that is useful when you're making a choice between one healthcare
provider and another, but that's not really an issue here. If there's a
complication and I end up here, I won't really have a choice in the
matter, and I'll just end up under whoever the consultant on call is at
the time, so I'm not sure that it'll be much use to me at that stage to
know whether their section rate is higher than I'm happy with.

I suppose the answers to a lot of questions about policies vary with
specific circumstances anyway, so they might tell me that such-and-such
is their policy in normal labours, but that won't necessarily mean it'll
apply to me as I'll only end up there if it's _not_ a normal labour. So
that might limit the use of any answers I get, but it'll still be good
to know more about the place. So - suggestions for questions are
welcomed. ;-)


All the best,

Sarah

--
"I'm just remembering what a perfect parent I was before I had a baby" -
Elfanie, misc.kids.pregnancy

In your shoes I'd ask about whether your midwife would
be able to accompany you as a support person, and in
which circumstances (e.g., c-section or not).

Emily

I think most units would expect the midwife caring for you to continue that
care and support, including if a c/section was required. The only reason
this would not be allowed to happen is if it was an independent midwife who
did not have insurance to work within in the hospital environment, but the
midwife would most likely still be able to stay in a support/birth partner
role.

its very difficult to know what questions to ask in this kind of situation,
most units now have breast feeding counsellors who are midwives, and I know
the NCT have loads of counsellors. If you have to go to hospital because
your labour deviates from normal, there is a high probability that you would
be monitored continuously and also they probably would not be keen for you
to eat and drink.

The only thing I can think to do is to think about what matters most to you.
I know that sounds a bit simplistic, but think what are you main concerns
during labour the things you really want and are really against, do the same
for the actual delivery, and for after care.

good luck and enjoy the tour

Helen the Midwife

"Emily" wrote in message
news:YB56d.62194$wV.3040@attbi_s54...
In your shoes I'd ask about whether your midwife would
be able to accompany you as a support person, and in
which circumstances (e.g., c-section or not).

Emily

In message , Helen
writes
The only thing I can think to do is to think about what matters most to
you. I know that sounds a bit simplistic, but think what are you main
concerns during labour the things you really want and are really
against, do the same for the actual delivery, and for after care.

Thanks - very sensible advice! What I was trying to avoid was the
situation where you're on your way home and think "Damn! I really
should have asked about such-and-such." Sometimes you can have a mental
block about something you realise later you really do want to know, and
I figured picking other people's brains might make that less likely.

Anyway - the tour was really interesting, and I feel a lot better about
the place now. The midwife who showed us round was very nice and it
sounds as if they really do try to keep things low-intervention if
possible. She said that they encourage skin-to-skin contact for up to
an hour right after birth unless mums really don't want it, and that
they'll encourage skin-to-skin contact in the recovery room after a
Caesarean as well. They have a birthing pool as well. They're also
trying to get their act together more with regards to breastfeeding, and
have a written policy of not giving breastfed babies any artificial
nipples, and also are starting to get volunteer breastfeeding
counsellors to come in to see breastfeeding women. So, now I feel a lot
happier about the possibility of ending up there if anything goes wrong.

I'm considering whether I should just book in there, simply because I
know DH would prefer me to be somewhere where emergency care is right on
hand. But I can't help feeling it might be better to be in the birthing
centre since, if I'm a twenty-minute ambulance ride away from a
Caesarean/forceps/Ventouse/epidural, at least I'll know that none of
those things will happen unless it's clear I really do need them, and it
won't be an "oh, well, this isn't going great so we might as well"
thing. Anyway, I can discuss it with my midwife when I see her.


All the best,

Sarah

--
"I once requested an urgent admission for a homeopath who had become depressed
and taken a massive underdose" - Phil Peverley

On Sat, 2 Oct 2004 13:24:25 +0100, Sarah Vaughan
wrote:


I'm considering whether I should just book in there, simply because I
know DH would prefer me to be somewhere where emergency care is right on
hand. But I can't help feeling it might be better to be in the birthing
centre since, if I'm a twenty-minute ambulance ride away from a
Caesarean/forceps/Ventouse/epidural,

....

Its worth remembering that you're probably at least 30 minutes from a
Caesarean/ventouse etc *anywhere*, including on L&D ward. I
questioned the OB last year about what they do if there is no one
available to do an emergency c-section (they lost a couple of babies
through that scenario last year). "Oh, she said "now they can bleep
us in within 30 minutes which is what we aim for as call to cut time
anyway". Very little goes wrong that quickly and realistically thats
the response time you'll get even if you're in the hospital by the
time they prep theatre and get staff in there.

I certainly think there is something to be said for putting epidurals,
if nothing else, slightly "out of reach" if what you want is a natural
birth, since I think a lot of women hit a stage of "give me the bloody
epidural anyway", generally during transition but sometimes earlier, I
know I did but it only lasted maybe half an hour and I would have been
very angry with myself had I had one because in the end I *could* cope
with it all just fine.

Megan
--
Seoras David Montgomery, 7th May 2003, 17 hours. http://seoras.farr-montgomery.com
EDD 11th March 2005

In message , Buzzy Bee
writes
On Sat, 2 Oct 2004 13:24:25 +0100, Sarah Vaughan
wrote:


I'm considering whether I should just book in there, simply because I
know DH would prefer me to be somewhere where emergency care is right on
hand. But I can't help feeling it might be better to be in the birthing
centre since, if I'm a twenty-minute ambulance ride away from a
Caesarean/forceps/Ventouse/epidural,

...

Its worth remembering that you're probably at least 30 minutes from a
Caesarean/ventouse etc *anywhere*, including on L&D ward.

Yes, this is what I thought, and why I feel that I'm likely to be just
as safe delivering in the birthing centre as in the hospital. Hopefully
I can convince DH of this......

I
questioned the OB last year about what they do if there is no one
available to do an emergency c-section (they lost a couple of babies
through that scenario last year). "Oh, she said "now they can bleep
us in within 30 minutes which is what we aim for as call to cut time
anyway". Very little goes wrong that quickly and realistically thats
the response time you'll get even if you're in the hospital by the
time they prep theatre and get staff in there.

I think that there are probably cases where a real emergency comes up
and where they actually could deal with you more quickly if you were in
the hospital rather than out of it - but those cases are surely very
rare, and on the other side of the coin, there are the cases where
something goes wrong just as a result of being in hospital, like a
hospital-acquired infection (granted, that could happen in the birthing
centre as well, but what I've heard about this hospital's infection
rates isn't great) or an unnecessary Caesarean (when I was doing
paediatrics, I saw one case of a Caesarean that was almost certainly due
to the fetal blood gas machine malfunctioning).

I certainly think there is something to be said for putting epidurals,
if nothing else, slightly "out of reach" if what you want is a natural
birth, since I think a lot of women hit a stage of "give me the bloody
epidural anyway", generally during transition but sometimes earlier, I
know I did but it only lasted maybe half an hour and I would have been
very angry with myself had I had one because in the end I *could* cope
with it all just fine.

This is the sort of thing I keep hearing from lots of different women -
that they get to the stage of thinking "Oh, my god, I can't stand much
more of this" and think they need analgesia, and then find out that in
fact there _wasn't_ much more of this to stand. In fact, the book I
read on the Bradley birthing method says that the 'self-doubt' stage is
actually a sign that the end of the first stage of labour is within
sight, even if the woman isn't very far dilated by that stage. And,
yes, this is exactly why I want to put myself in a situation where
getting the epidural is going to be a bit more complicated than just
asking for it.

Of course, it'll still be possible for the midwives to give me
pethidine, which is more likely to cause second-stage problems than
epidurals. One thing I'm going to specify and highlight on my birth
plan is that I don't want to be offered analgesia even if I'm screaming
and shouting that I can't stand it any longer, because a) this might be
my way of coping with the pain and b) if things get to that stage then
what I _really_ want is to be told I'm doing brilliantly and encouraged
to keep going for a bit longer.


All the best,

Sarah


--
"I once requested an urgent admission for a homeopath who had become depressed
and taken a massive underdose" - Phil Peverley

Sarah Vaughan wrote:


And,
yes, this is exactly why I want to put myself in a situation where
getting the epidural is going to be a bit more complicated than just
asking for it.

I think putting yourself in an environment where
drugs are not expected and where you have caregivers who
are experienced at supporting unmedicated birth goes
a *long* way towards increasing your chances of going
unmedicated. In the US, homebirth and birthing center
transport rates tend to be under 10 percent, meaning
that the vast majority of women who want to go
unmedicated and put themselves in an environment where
success is likely *do*, in fact, succeed at going
unmedicated.

Best wishes,
Ericka

In message , Ericka Kammerer
writes
Sarah Vaughan wrote:


And, yes, this is exactly why I want to put myself in a situation
where getting the epidural is going to be a bit more complicated than
just asking for it.

I think putting yourself in an environment where
drugs are not expected and where you have caregivers who
are experienced at supporting unmedicated birth goes
a *long* way towards increasing your chances of going
unmedicated. In the US, homebirth and birthing center
transport rates tend to be under 10 percent, meaning
that the vast majority of women who want to go
unmedicated and put themselves in an environment where
success is likely *do*, in fact, succeed at going
unmedicated.

Well, when I saw my midwife today she mentioned something about extra
interventions in hospital, so DH asked her what sort of interventions
she thought it was best to avoid. She said 'Breaking the waters early,
expecting women to lie on the bed too early instead of moving around,
giving pethidine, giving epidurals'. I thought 'Yaaaaay! My kind of
midwife.' ;-) I hope the other midwives at the birthing centre feel the
same way!


All the best,

Sarah
--
"I once requested an urgent admission for a homeopath who had become depressed
and taken a massive underdose" - Phil Peverley